危重症休克患儿骨髓腔输液的最佳证据总结  

Summary of best evidence for intraosseous infusion in critically ill shocked children

作　　者：张一帆 马艳杰 李蕊 于淑坤[4] 刘琪琪 管亚辉 李淑敏 李晶晶 倪嘉欣 刘倩 Zhang Yifan;Ma Yanjie;Li Rui;Yu Shukun;Liu Qiqi;Guan Yahui;Li Shumin;Li Jingjing;Ni Jiaxin;Liu Qian(School of Nursing,Beihua University,Jilin 132013,China)

机构地区：[1]北华大学护理学院,吉林吉林132013 [2]江南大学无锡医学院护理系 [3]上海交通大学医学院附属同仁医院护理部 [4]北华大学附属医院护理部

出　　处：《护理学杂志》2025年第5期51-56,共6页Journal of Nursing Science

摘　　要：目的检索、评价和整合危重症休克患儿骨髓腔输液的相关证据,为准确实施骨髓腔输液提供证据支持。方法使用计算机检索相关数据库中关于危重症休克患儿骨髓腔输液治疗的证据,包括临床决策、指南、专家共识、系统评价、证据总结和随机对照试验,检索时限为建库至2024年5月。结果共纳入8篇文献,包括临床决策1篇、指南1篇、专家共识3篇、系统评价2篇、随机对照试验1篇。从骨髓腔输液通路的适应证及禁忌证、穿刺设备、穿刺部位、皮肤消毒、药物性质、输液速度、骨髓腔输液通路移除、疼痛管理、并发症的预防及处理、操作资质及教育培训10个方面,共总结了40条证据。结论本研究总结了危重症休克患儿骨髓腔输液的最佳证据,可为医护人员准确实施骨髓腔输液提供参考,建议医护人员结合临床情景及患儿实际情况应用证据。Objective To retrieve,evaluate,and integrate evidence related to intraosseous infusion in critically ill shocked children,and to provide evidence support for accurate implementation of intraosseous infusion.Methods Relevant databases were searched for evidence on the treatment of intraosseous infusion in critically ill shocked children,including clinical decisions,guidelines,expert consensus,systematic reviews,evidence summaries,and randomized controlled trials.The retrieval timeframe was from the establishment of the database to May 2024.Results A total of 8 publications were included,containing 1 clinical decision,1 guideline,3 expert consensus reports,2 systematic reviews,and 1 randomized controlled trial.A total of 40 pieces of evidence were summarized into 10 areas,including indications and contraindications for intraosseous infusion access,puncture equipment,puncture site,skin disinfection,nature of the drug,speed of infusion,removal of intraosseous infusion access,pain management,prevention and management of complications,operation qualification,and education and training.Conclusion This study summarizes the best evidence for intraosseous infusion in critically ill shocked children,which can provide reference for healthcare professionals to accurately implement intraosseous infusion,and it is recommended that healthcare professionals apply the evidence according to the clinical scenarios and the actual situation of the child.

关 键 词：患儿 危重症 休克 骨髓腔输液 药物治疗 证据总结 循证护理 

分 类 号：R472[医药卫生—护理学]